TORONTO - The Ontario budget's pledge to reduce emergency room wait times will do little to ease the pressure on hospitals unless action is taken to free up acute-care beds for emergency patients, the head of the province's hospital association said Wednesday.

Some 20 per cent of acute-care beds across the province are occupied by people who should be discharged but are unable to find adequate home care and long-term care, said Tom Closson.

That number of patients has grown in the last 18 months, making it harder for hospitals to admit emergency patients, Closson said.

The provincial budget, introduced Tuesday, pledged $180 million over the next three years to lower wait times in emergency departments and improve "patient satisfaction.''

But it's going to be hard to lower wait times unless the province finds a way to free up those beds, Closson said.

"It's challenging to get patients out of the emergency department and into hospital beds because the beds, in many cases, are full,'' he said.

"It's then challenging to have short wait times in the emergency department because the emergency department is feeling overloaded. The solution is primarily in the community, it's not in the hospital.''

The $96-billion Liberal budget boosted health-care spending by $2 billion, with half of that going to hospitals. But it's not clear how much of that will help 75 of the province's 154 public hospitals facing a deficit this year, Closson said.

The Liberals have based funding on an inflation rate which doesn't take into account increased energy costs and rising wages, he said. Hospitals have to balance their books by the end of the month, giving them limited time to figure out whether Tuesday's budget will give them the extra help they need, he said.

"Hospitals are generally efficient in the first place,'' Closson said. "You can only improve your efficiency by so much each year. It takes a lot of work.''

Health Minister George Smitherman said hospitals have some flexibility to balance their books over two years if need be. Some hospitals are only facing a small deficit of about one per cent, he said.

The province isn't finished boosting home care or long-term care to reduce wait times in emergency rooms, Smitherman added. The Liberals announced a $700 million aging-at-home program last year which is still being rolled out, he said.

But hospitals also have a significant pool of money to work with as well, he said.

"No one pretends that the work that they're doing in hospitals is easy,'' Smitherman said, adding they received a 5.6 per cent funding boost in the budget.

"When you have a $15-billion base and you add 5.6 per cent to it, that's a substantial portion of money from the people of the province of Ontario.''

But Conservative Elizabeth Witmer said Ontario hospitals are as lean as they can get. Hospitals have already eliminated the "low-hanging fruit,'' she said, and are now looking at cutting staff and operating room time.

Putting more pressure on hospitals to cut emergency wait times when they don't have the acute-care beds doesn't help, Witmer said.

"This is a very serious situation,'' she said. "The hospitals, after the budget, continue to be extremely concerned that there wasn't enough money to eliminate the deficits they're facing this year and there wasn't enough money or a plan to deal with the emergency room problems.''

NDP Leader Howard Hampton said the Liberals don't have a strategy to seriously reduce the amount of time people spend waiting in emergency rooms.

"It's a PR strategy but the hospitals are right,'' he said. "The money isn't there, so I think you're going to see emergency room waits get worse.''